The TopClosure® Tension Relief System (TRS) is a novel device for wound stretching, closure and secure. It applies controlled, incremental, and evenly-distributed tension relief, over a wide area of attachment away from wound margins. The TopClosure® TRS attaches to the skin both invasively and noninvasively, in a dynamic, adjustable, reversible, zipper-like manner allowing skin stretching by both mechanical creep and stress relaxation.

We present a diverse series of infected limb amputation due to diabetes, peripheral vascular daisies and trauma where combined ROI-NPT and TRS were applied for early resolution of infection and primary closure of the stump, substituting for skin grafts or flaps with improved fitting of prosthetics and better functionality.

The combination of TRS and ROI-NPT alters the three phases of wound healing by reducing inflammation, eliminating the need for lengthy proliferation of granulation tissue, reaching early maturation and enabling improved functionality. This unique synergistic effect provides a totally new concept of wound management that changes perceptions of infected amputation wound closure, and instituting new standards of care for optimizing wound healing and functionality.